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Home My WebLink Aboutbld-20-004044 „% -, .Coco Ilse Only 7: ;, as Q` - � :,, Amount e's�,�° , , Permit expires 180 days from issue date EXPRESS BUILDING PERMIT APPLICATIO TOWN OF YARMOUTH R .E C E Yarmouth Building Department ” 1146 Route 28 JAN ,?3 202'' ' South Yarmouth,MA 02664 i (508)398-2231 Ext. 1261 I E ARTMENT By' < CONSTRUCTION-ADDRESS: ZO / v y O4ks c2 rc% ASSESSOR'S INFORMATION: Map: Parcel: • OWNER:Nttr/t'WS.lfy .2o& aw* Cr rege,fl,/�f r-I/� 016,7 5 s bl 341 8s'3S' AI p �c tmaitAddre N /O IIeSE ✓D_ TEL „ CONTRACTOR: ufmrn N lZ in auu Sri.-#-F'-e%f R-2 o A'7 . CPO '2 AME MAILING ADD S T .-9TEL.# Email Ad, Residential Commercial Est Cost of Construction 3 i Zvi 2 5/6 — Home Improvement Contractor Lie.# !73 2.5fs Construction Supervisor Lic.# OT67D 7 Workman's Compensation Insurance: (check one) . I am the homeowner I am the sole proprietor have Worker's Compensation Insurance InsuranceCompany1 Worker's Comp.Policy# 4)GA.afar 72.92, . Com an Name: l��l>�IE�S l�5. � � - , WQIK TO BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares - Replacement windows:# / Replacement doors: # 3 Roofing: #of Squares ( )Remove existing*(max.2 layers) Insulation ngs Highway/Historic Dist. ( )Replacing like for like *The debris will be disposed of an Wh de "IA.,'a ((.P/ft � i.bcstion of I declare under penalties of perjury that the s,. ,,,, ,.herein contained are true and correct to the best of my knowledge and belief. 'understand that any false answer(E wili be just cause for denial. -•oration of m? a,se and for prosecution under M.G.L Ch.26L Section 1. Applicant's Si: 10 • • Date: [/ZZ/ 2 d Owners :.,,:tore(or.••: ,,/_„, r ' ' Date: Approved B _ii - i. ;r � r Date. / ' 2 3-2U 20 APPm Building is ., �� Zoning District Historical District Yes No Flood Plain Zone: Yes No Water Resource Protection District Within 100 it.of Wetlands: Yes No Yes No Renewal Agreement Document and Payment Terms MAndersen. dba:Renewal By Andersen of Southern New England Mark Reilly / • ��' Legal Name:Southern New England Windows,LLC 20 Many Oaks Circle • RI#36079, MA#173245,CT#0634555, Lead Firm#1237 Yarmouth Port,MA 02675 WINDOW RELACEMINT 10 Reservoir Rd I Smithfield,RI 02917 H:(508)364-8535 Phone:401-349-1384 I Fax:401-633-6602 I sales@renewalsne.com Buyer(s)Name: Mark Reilly Contract Date: 11/23/19 Buyer(s)Street Address: 20 Many Oaks Circle, Yarmouth Port, MA 02675 Primary Telephone Number: (508)364-8535 Secondary Telephone Number: Primary Email: mtreillydvm@yahoo.com Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: 516,246 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $5,415 Balance Due: S10,831 Estimated Start: Estimated Completion: Amount Financed: SO -9 weeks 7-9 weeks Method of Payment: Credit Card We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 1/3 deposit,1/3 at start,1/3 at completion Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s) and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 11/27/2019 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Ren y An n of Southern New England Buyer(s) iG"'!�[/rr'ti Signature of Sales Person Signature Signature Paul Sandrey Mark Reilly Print Name of Sales Person Print Name Print Name UPDATED: 11/23/19 Page 2 / 10 e (Jc v2 2(1rwteed . aK`�letef, Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: 173245 SOUTHERN NEW ENGLAND WINDOWS,LLC Expiration: 09/18/2020 10 RESERVOIR ROAD SMITHFIELD, RI 02917 Update Address and Return Card. SCA 1 Co 20M-05/17 Te cvmv, w eetz&cyf,l4m:-� ca clG: Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Reaistratioq Expiration Office of Consumer Affairs and Business Regulation 173248' 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW ENGLAND WINDOWS,LLC Boston,MA 0211 BRIAN DENNISON I 10 RESERVOIR ROAD ° y SMITHFIELD,RI 02917 Undersecretary Nu,. 1 without signature r . Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructforj Supervisor CS-095707 EXpires. 09/08/2020 -- ► y BRIAN D DENNISON 8 BLACKWELL DRIVE ; `,:' CHARLTON MA 01507 --' �a Q•, c.L. isaril___... Commissioner _`"_ The Commonwealth'of Manachusetts Department of indaistrialAccidents _:_LLem� - i Con;ressStreet,Suite 100 ~. ti7f y Boston,MA 02114-2017 :,. nnvw.mass.gov/dia Workers'Compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Anolicsat Information Please Print Legibly Name(Business/or�aniration/Individual): S b4t�'h e r p1. 'Veto tc /G, &0/I DLtJ. Address: 1 ) ,ce rr Uot r �J City/State/Zip:Spp t -6 tie"t]'l OZQ /7 Phone#: 40/-ZZ r- ? t? Are you an employer?Check the appropriate box: Type of project(required): I. I am a employer with O'ZLemployees(full and/or part-time).* 7. ❑New construction am a sole proprietor or partnership and have no employees working fir me in 8: Q Remodeling any capacity.[No workers'comp.insurance required]• 9. ❑Demolition 3.Q I am a homeowner doing all work myselz[No workers'comp.insurance requirectl r 4.0 I ara a homeowner and will he contractors to conduct all waricon m 10 Building addition �S Y property. 1 will ensure that all contractors either have workers'compensation insurance or are sole I L.Q Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions • 5.0[am a general contractor and[have hired the sub-cotrractors listed on the attached sheet 13.0 Roof repairs , These sub-contractors have employees and have workers'comp.insurance.: 6. We are a corporation and its officers have exercised their right14.Q Other i rpo of exemption per MOL n 152,i 1(4).and we have no employees.[No workers'comp.insurance required.] _Pei, /�n, I e, ' *My applicant that checks Weil must also fill out the section below showing thew workers'compensation policy' Ar�limatt�on. • t Homeowners who submit this affidavit indicating they are doing all work and then hire outside caniractors mum submits new affidavit indicating such ;Contractors that check this box must attached an additional sheet showing the Rams of the sub-contactors and state whether or not those entities have tun'loyeea. Ifthe sub-caattact+as have empiayeas.they must provide their motion'- ,, policy number. I am an employer that is providing workers'compensation insurancefor my employees Below is the policy and Job site Warn:dim *Ft , Insurance Company Name: r � Ill ranee,_ a • OF ,A IAA, b. a . Polio#or Self-ins.Lic.#: t)C.A3/SC7 cR?O? . Expiration I' -2-D Z f Job Site Address: ()4f lip City/State.Zip: rr'/ 14,4 Attach a copyof the workers'con sadon policydeclaration page(showingthe It n bar and expiration date). Pe t� eY p ) Failure to secure coverage as required under MGL c. [52,§25A is a criminal violation punishable by a fine up to S 1,500.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violabi'.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage vd on. I do hereby co •, underthe ,,, • ,makes*slimythat the lnformationprovided abov is five; ' correct -- ZZ r j'hone# 101 2,24 — 9 00 Official use only. Do not write in this area,to be completed by city or town ofcieL City or Town: Permit/License 8 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing Inspector 6.Otber Contact Person: Phone#: ACCWEI CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/30/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT BOKF Insurance CO Risk Management PHONE FAX 1600 Broadway,9th Floor • (AIC.No.Ext):303-988-0446 (A/c,No):303-988-0804 Denver CO 80202 EADD TRESS: insure@bokf.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER B:Firemen's Insurance Company of WA,D.C. 21784 Southern New England Windows, LLC dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURERE: • INSURER F: COVERAGES CERTIFICATE NUMBER:1098683046 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADM SUBR POLICY EFF POLICY EXP V�r$ LTR ekSD WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL UABIUTY CPA3158728 1/1/2020 1/12021 EACH OCCURRENCE $1,000,000 , DAMAGE T CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $300 000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMB APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY F E& LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/112020 1/1/2021 COMBINED SINGLE LIMIT(Ea accident) $1.000.000 X ANY AUTO BODILY INJURY(Per person) $ — ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X AUTONON-OWNED PROPERTY DAMAGE $ X _ HIRED AUTOS _ AUTOS (Per accident) $ A X UMBRELLA UAB X OCCUR CPA3158728 1/1/2020 1/1/2021 EACH OCCURRENCE $15,000,000 - EXCESS WWI CLAIMS-MADE AGGREGATE $15,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION WCA315872922 1/1/2020 1/1/2021 X STATUTE ER AND EMPLOYERS'LIABILITY ANY PROPIEM OR/PARLNR ER/EXECUTIVE Y( , N/A E.L.EACH ACCIDENT $1,000,000 (Mandatory In NH) ' " ) E.L.DISEASE-EA EMPLOYEE $1,000,000 UyyesSGtRIPTION TIOe DE OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 C Pollution Liability 7930073340002 1/1/2020 1/1/2021 Each Occurrence Claims-MadePolicy Aggregate $2 000,000 Retroactive Date 08/2�13 Deductible $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N more space Is required) Subject to all policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE eclat 54trielftpyI 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD